Insight in the consistency of care pathway of patients newly diagnosed with stage 1A1 cervical cancer


  • Sujjanna A. L. Manuel Department of Obstetrics and Gynecology, City Hospital Nottingham University Hospital NHS Trust, Nottingham, United Kingdom
  • David Nunns Department of Gynecology, Nottingham University Hospital NHS Trust, Nottingham, United Kingdom



Colposcopy, Follow up, Hysterectomy, LLETZ, LVSI, Stage 1A1cervical cancer


Background: This study aimed to assess the consistency of care pathway in patients diagnosed with stage 1A1 cervical cancer in our hospital.

Methods: Retrospective analysis of care pathway of patients with stage 1A1 cervical cancer over the last 5years 2017-2022 by accessing their electronic records. Data collected were, information given to patients and their GP of cancer diagnosis, access to clinical nurse specialist, patient information leaflet, Multidisciplinary Team review, discussion of treatment following primary LLETZ and follow up.

Results: Total 45 patients were diagnosed with stage 1A1 cervical cancer.  All patients and their GPs were sent letters about their diagnosis and plan for further management   after multidisciplinary team discussion.  Access to clinical nurse specialists noted in 16, and provision of patient information leaflet noted in 9 patient records. Regarding treatment 14 patients had a repeat LLETZ, 7 patients underwent hysterectomy, 5 patients had a second LLETZ procedure followed by hysterectomy and 19 had routine follow up (colposcopy and cervical smear). Follow up of the 33 patients who had LLETZ as definitive treatment, 1patient had recurrence of cancer and 2 patients had low grade dyskaryosis. Histology post hysterectomy, 5 patients had no evidence of CIN, 6 patients showed CIN with complete excision, and no cases of CIN with incomplete excision.  All vault smears were negative for malignancy.

Conclusions: The clinical standards of management were in par with expectations, however, to improve unmet holistic needs (access to information of support groups, clinical nurse specialists, patient information leaflets).


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Original Research Articles